Inspection on 09/08/05 for Westwards House Residential Care Home

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Westwards House Residential Care... 08/05/07

Westwards House Residential Care... 16/01/06

Westwards House Residential Care... 14/12/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Westwards House Residential Care Home 18 Croston Road Garstang Lancashire PR3 1EN Lead Inspector Jenny Hughes Announced 9 August 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Westwards House Residential Care Home Address 18 Croston Road Garstang Lancashire PR3 1EN 01995 602055 01995 600967 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BLHC Westwards House Limited Mrs Janet Houlker Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 14th December 2004 Brief Description of the Service: The home is a two storey purpose built care home in the centre of the town of Garstang, where there is easy access to local transport links. There are attractive gardens at the rear of the property, with lawns, patio area, flower beds and a water feature, where residents can sit and enjoy the sunshine. There is a small car park at the front of the home, and easy parking in the roads alongside the home. The home provides personal care for older people, and is equipped to suit the needs of its residents. For example, a stair lift has been installed, and ramps are provided for wheelchair access. There are fifteen single and two double rooms, most of which are ensuite. Toilets and bathrooms are conveniently located. There is sufficient communal space, made up of a lounge, dining room, and a conservatory. The home has a no smoking policy. Staffing is provided over 24 hours, every day of the year. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours, and was one of two inspections which must be made each year. Additional inspections may be made if necessary. The inspection was announced, in that the owner was aware that the inspection was to take place. The registered manager was interviewed, and three staff and eight residents were spoken to. Surveys were sent out to residents, relatives, and to G.P’s involved with the home, and all of their views were also taken into account. Staff and care records were inspected, and policies and procedures were viewed. What the service does well: The home has some long term, experienced staff, who lead by example, encouraging good practices and attitudes in any new staff. Staff training is ongoing at all levels, to make sure their knowledge in caring for people is as up to date as possible. Assessments and care plans are clear and detailed, for staff to understand how best to look after each individual. They show all areas of need, alongside their likes and dislikes and preferred daily routines. Daily records are detailed and complete. A local GP who visits the home’s residents commented, ”Overall an excellent home with a good standard of care. Staff are personal, professional, and know the residents very well indeed”. Visitors are welcome at any time, with communal space available to have private chats. The manager likes to always make herself available to families visiting. Meals are home-cooked, varied, with well-balanced choices. They are well presented, with meal times being pleasant and unrushed. Some activities are encouraged, with visiting families welcome to join in. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home has a comprehensive assessment that is carried out for all residents. This means that a service is provided that is tailored to the individual’s needs and preferences. EVIDENCE: Individual records are kept for each of the residents, and there is a set procedure for admitting someone to the home. The manager has adopted a new system of assessment and care planning since the last inspection, which was in line with the other care homes owned by the company. The manager completes a comprehensive assessment of need with the prospective resident, and both sign to confirm agreement. Examples of these were seen on three selected files. The information was relevant, appropriate, and complete, detailing physical, psychological and social needs. The manager then can check that the staff are able to give suitable care to the person, before it is agreed that the home is the right place for them to live. This information then becomes a plan of care for daily living for each resident. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 9 One resident said that she visited the home “to have a look around”, before she decided to stay. Another resident said “I knew all about this place from my daughter. They (the staff) know all about me you know. They know what I like and what I don’t like, and what my little problems are. I think they like to make sure they get it right.” A GP responded to a survey saying that the manager incorporates any specialist advice they may give about a resident into their care plan, and that staff demonstrated a clear understanding of the care needs of residents. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 The health and personal care needs are well met in this home. Residents benefit from the support of healthcare professionals. EVIDENCE: Individual care plans are available, identifying the areas of need for each person, and with clear instructions for staff on what they must do to meet that need. Any risk was clearly identified, followed by what action to take to manage it. One resident had a history of falling, and records were seen of monitoring these, along with communication with family regarding the concerns, and suggestions of possible ways to help overcome the problem. Another resident had been identified with some weight gain, and records showed her agreement to more activity, with gentle walks and exercise sessions, and participation in arts and crafts sessions. Residents spoken to were aware that they had a file holding their information, but said, “We don’t need to see that. They look after us OK.” Staff said that they could always check resident’s information on their files, and they made Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 11 daily entries regarding the wellbeing of each resident, to help make sure the care needed was fully given. Reviews of the care plans were seen to take place every month, more often if necessary. Full records of any GP’s visits were seen for each resident, and visits from other professional services, such as district nurses, dentists, opticians, chiropodists, and physiotherapists were recorded. All of the residents choose what they wish to do through the day, with some sitting in the conservatory reading, some in the lounge, and some returning to their rooms. As it was a nice day, a few chose to sit in the garden in the sunshine, either quietly alone, or chatting with a friend. Staff ensured the residents enjoyed their own private space, which was appreciated by the residents. “You can really do what you want. And the girls will always help you” Staff were seen to be patient, friendly and efficient in carrying out their work. “They’re a good lot of girls”, commented one resident. “I sometimes go and sit in my room if I want to be quiet. The girls are good and knock on my door to come in”. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Residents experience a good quality of life in this area. The dietary needs of residents are catered for, with a balanced and varied selection of food available that generally meets residents tastes and choices. There are some activities, and some residents are motivated and stimulated by joining in. EVIDENCE: The manager tries to identify individual hobbies and interests during the initial assessment, and the keyworker for each person then tries to support that interest in the home. Records are made of activities carried out with each person, which may simply be a chat, while enjoying ice-lollies in the garden, board games, crafts, or encouragement to join in group activities such as bingo, or sing a longs, although staff did comment that some people were happier not joining in. One resident liked to paint, and paints and brushes were provided so that she could carry on with her hobby, which she preferred to do in her own room. She proudly showed the inspector her latest artwork, and stated, “I only have to ask you know, and they’ll try and get what I need.” The home had recently held a Garden Party, which the residents said they enjoyed with their families. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 13 Staff said that they liked to think of different things for residents to do, and were seen having their lunch while discussing what activities the residents might enjoy. Visitors are welcome at any time, with a visitor’s book showing regular callers to the home. “ My grandson calls to see me”, commented one resident, “they all know him now. We sit and chat in my room, and the staff bring us a drink if he wants one”. Regular communication is encouraged, and the manager has started producing a one to two monthly newsletter, which is for all residents, friends and families, and anyone who has contact with the home. It gives up to date news about events in the home. The latest one informs about the success of the garden party, welcomes new staff and residents, lists birthdays of staff and residents, and lets the reader know what training staff have recently undertaken. Meals are served in the dining room, although residents can eat in their own room if they wish, which was the case for a couple of people during the inspection visit. Particular likes and dislikes of residents are noted during their initial assessment, and special dietary needs are recorded in the kitchen. There is a four weekly menu in place, with other choices available alongside the main meal, in case anyone wants something different. “It’s good food most of the time. Sometimes there’s something I don’t really like, or it’s not cooked right, but I can have something else then”, said one resident. “It’s alright. Not bad. Not brilliant.” said another. The meal sampled was braised steak with potatoes, vegetables and gravy. It was tasty enough, although some of the residents found the meat a little tough. A last minute substitute for banana custard produced plain sponge and custard, which would have benefited from a little more flavour, with jam or suchlike. Some residents preferred a yoghurt for sweet, which they were given and enjoyed. Hot and cold drinks were freely available. Residents clearly felt able to let staff know if they did not want or like something, or if they wanted another drink, or more gravy, and staff were happy to oblige. For residents needing help, staff assisted discreetly, and the mealtime was calm and unhurried. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents are confident their concerns will be listened to and acted upon. Staff have an understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. The home’s complaints book has no records of a complaint. The manager commented that any minor concerns are dealt with immediately, to try and keep the residents as happy as possible in their home. These may be little worries that residents have, such as a television being too loud in a resident’s room, or someone sitting in a favourite chair, things which staff can try to address straight away. The residents were all aware of who to tell if they were not happy about something. “I’d tell any of them. Janet’s the manager though. I could tell her”, and “They always ask if I’m alright or if I want anything. I’d say if I did. I think everyone here would. We’re not slow at coming forward “, were two comments from residents. Staff spoken to knew about the Adult Protection procedure, and what to do if they had any concerns. They said they would always act if they thought a resident was at risk. Also if it was a member of staff causing concern they would inform the manager. All staff attend abuse awareness training. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected at this visit. EVIDENCE: These standards were not inspected at this visit. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are offered an appointment. Training is provided and this means that residents are provided with appropriate care and attention. There is an enthusiastic and experienced workforce, which works positively with residents to improve their quality of life. EVIDENCE: Five new staff had been recruited since the last inspection, and files showed that the necessary recruitment checks are carried out to ensure the protection of residents. References and Criminal Records Bureau checks were available. All new staff are required to have full induction training, so that they are clear on what is expected of them when they are carrying out their work. All the areas covered in the induction are signed by the manager and staff to show it has been completed. The staff group is made up of generally long-term and experienced care staff, who are able to guide and support the newer members of the team. “I’ve not been here very long, but I’m on with my NVQ training, and I really like it, it’s a nice place to work,” said one staff member, “Any of the more experienced staff will always help you if you’re not sure”. Training is ongoing, with a variety of courses being attended by staff. These include, food hygiene, health and safety, moving and handling, first aid, Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 17 medication awareness, infection control and NVQ Level 2 and Level 3. Due to some staff leaving, the number of NVQ qualified staff has reduced to 20 from 58 . However, there will always be some movement in this figure, and staff training is continuous. The manager stated that staff are encouraged to increase their knowledge themselves, and a good selection of reference books are available for all the staff team in the training room in the home. The rota showed which shifts the care staff were working each day. The manager stated that the numbers of staff required in the home have been calculated according to the level of need of the individuals, so this may change dependant on who is resident in the home. At the time of the inspection, the numbers of staff on duty were appropriate. “You can always get hold of somebody if you need help. It’s not a very big place is it? The girls are never far away”, said a resident. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 The systems for consulting with residents and their families are generally good, with a variety of evidence that shows that resident’s views are both sought and acted upon. Systems and practices in the home promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: There are systems used in the home to regularly audit and monitor standards, and to get feedback from residents and their families on their level of satisfaction with the service. An annual survey is sent to residents and visitors of the home. This is collated, and any action required in response to these can then be made. New residents complete a trial period questionnaire, and an interim survey may be used for feedback on a particular issue or activity. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 19 A survey is also sent out to staff twice a year, to measure their satisfaction with the company and its management and training of staff. The home has been successful in achieving the Investors in People Award, which recognises achievements in developing and training staff. The company regularly audit all records in the home to make sure they are fully completed and up to date. Good communication systems are in place between the staff and the manager, and the manager and the company head office. Daily reports are completed, by senior care staff, of pertinent events in the home regarding the residents, for the manager to view and monitor, and the manager sends weekly reports to head office regarding issues around maintenance needs, accidents, and hospital admissions, for example. As the manager stated “It is only a small home, and staff on duty are speaking to each other and the residents all of the time. I always try to make sure I am available if anyone wants a private word”. Clear records are kept of anything to do with resident’s finances, and a safe is available if anyone needs it. Records and staff confirmed the regular fire training for staff, with recorded visits showing fire equipment having been checked. All maintenance and servicing checks of equipment were correct. Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 4 x 3 x x 3 Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection North Lancs Area Office Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Westwards House Residential Care Home F57-F09 S61814 Westwards House V207387 090805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!